Sandbox Rim: Difference between revisions
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{{Family tree/start}} | {{Family tree/start}} | ||
{{ Family tree | | | | | | | | | | | | | | {{ Family tree | | | | | | | | | | | | | A01 | | | | | | | A01= '''Primary MR'''}} | ||
{{ Family tree | | | | | | | | | | | | | |!| | | | | | | | }} | |||
{{ Family tree | | | | | | | | | | | | | B01 | | | | | | | B01= What is the severity of MR? }} | |||
{{ Family tree | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| |}} | {{ Family tree | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| |}} | ||
{{ Family tree | | | | | | | C01 | | | | | | | | | | C02 | C01= '''Severe MR''' <br> | {{ Family tree | | | | | | | C01 | | | | | | | | | | C02 | C01= '''Severe MR''' <br> | ||
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❑ Regurgitation volume ≥ 60ml | ❑ Regurgitation volume ≥ 60ml | ||
❑ Effective regurgitation orifice ≥ 0.4cm² | ❑ Effective regurgitation orifice ≥ 0.4cm² | ||
❑ Vena contracta ≥ 0.7cm | C02= '''Progressive MR'''<br> | ❑ Vena contracta ≥ 0.7cm | C02= '''Progressive MR'''<br> ''(Stage B)'' <br> | ||
❑ Severe MVP with normal coaptation | ❑ Severe MVP with normal coaptation | ||
❑ RHD with normal coaptation | ❑ RHD with normal coaptation | ||
Revision as of 15:23, 3 September 2014
| Primary MR | |||||||||||||||||||||||||||||||||||||||||||
| What is the severity of MR? | |||||||||||||||||||||||||||||||||||||||||||
| Severe MR ❑ Severe MVP with loss of coaptation ❑ RHD with loss of central coaptation ❑ Left ventricular dilation ❑ Regurgitation fraction ≥ 50% ❑ Regurgitation volume ≥ 60ml ❑ Effective regurgitation orifice ≥ 0.4cm² ❑ Vena contracta ≥ 0.7cm | Progressive MR (Stage B) ❑ Severe MVP with normal coaptation ❑ RHD with normal coaptation ❑ No Left ventricular dilation ❑ Regurgitation fraction < 50% ❑ Regurgitation volume < 60ml ❑ Effective regurgitation orifice < 0.4cm² ❑ Vena contracta < 0.7cm | ||||||||||||||||||||||||||||||||||||||||||
| Is the patient symptomatic? | |||||||||||||||||||||||||||||||||||||||||||
| Yes (Stage D) | No (Stage C) | ||||||||||||||||||||||||||||||||||||||||||
| Is the LVEF>30%? | LVEF 30-60% OR LVESV≥40 mm (Stage C2) | LVEF>60% AND LVESV<40 mm (Stage C1) | New onset AF OR PASP>50 mmHg (Stage C1) | ||||||||||||||||||||||||||||||||||||||||
| Is the likelihood of success for the valve repair >95% and the expected mortality <1%? | |||||||||||||||||||||||||||||||||||||||||||
| No | Yes | Yes | No | ||||||||||||||||||||||||||||||||||||||||
| Mitral valve surgery (Class IIb) | Mitral valve surgery (Class I) | Mitral valve repair (Class IIa) | Periodic monitoring | Periodic monitoring | |||||||||||||||||||||||||||||||||||||||